Multivisceral resection for gastric cancer: a systematic review

作者：Brar Savtaj S; Seevaratnam Rajini; Cardoso Roberta; Yohanathan Lavanya; Law Calvin; Helyer Lucy; Coburn Natalie G^*

来源：Gastric Cancer, 2012, 15(S1): S100-S107.

DOI：10.1007/s10120-011-0074-9

• Gastric cancer
• Surgery
• Multivisceral resection
• Margins

Background The overall prognosis and survival of patients with advanced gastric cancer is generally poor. One of the most powerful predictors of outcomes in gastric cancer surgery is an R0 resection. However, the extent of the required surgical resection and the additional benefit of multivisceral resection (MVR) are controversial. %26lt;br%26gt;Methods Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 31, 2009. All search titles and abstracts were independently rated for relevance by a minimum of two reviewers. %26lt;br%26gt;Results Seventeen studies were included in this review. Among the 1343 patients who underwent MVR, overall complication rates ranged from 11.8 to 90.5%. Perioperative mortality was found to be 0-15%. Pathological T4 disease was confirmed in 28.8-89% of patients. R0 resection and extent of nodal involvement were important predictors of survival in patients undergoing MVR. Patient outcomes may also be affected by the number of organs resected. %26lt;br%26gt;Conclusions Gastrectomy with MVR can be safely pursued in patients with locally advanced gastric cancer to achieve an R0 resection. MVR may not be beneficial in patients with extensive nodal disease.

• 出版日期2012-9